When you have painful sex, it’s easy to think you must be alone in this experience. However, you’re absolutely not! Many people share your concerns, and there are many potential treatment approaches to make sex pain-free.
Especially in the genital area, the nervous system is sensitive to feelings of pain and “threat.” Regardless of why sex was initially painful, our body tries to guard against this negative experience the next time. Our beliefs about sex and the relationship with our partner(s) can also influence our body’s response. Over time, this can reinforce pain with sex because the body’s responses actually make it more uncomfortable to have sex. This reaction can create physical tension and muscle guarding, a higher sensitivity to touch, and a lower desire for sex.
When you come to pelvic physical therapy, your PT will:
Ask questions about your pain experience and the circumstances around when it started (if you know them)
Screen you for medical contributions to pain, and refer you to a doctor for further testing if needed
Seek to understand your goals for PT. What sexual activities do you want to participate in? Are you trying to conceive? Do you need to be able to tolerate routine tests? Etc.
If you do not have medical contributors to your pain, or they’re being appropriately managed, pelvic PT is the perfect place to work on teaching your body to be less sensitive to penetrative activities.
Pelvic physical therapy sessions may include:
Education about pelvic floor anatomy and how the pelvic floor muscles work
Practicing consciously contracting and relaxing the pelvic floor muscles to gain control and confidence
Learning about the physiology of sex, and how to set yourself up for success with foreplay, lubricants, etc.
Discussing options for maintaining or regaining sexual connection with your partner, if you currently have one
Using vaginal or anal dilators in the clinic and at home
Using mindfulness strategies to calm the body’s stress responses during your day as well as during sex
It’s important to know that no matter your experience, pelvic PT is a safe and judgment-free place. You can learn about your body, ask questions about sex, and work towards your individual goals in a supportive environment. We’re looking forward to working with you!
Heather earned her Doctor of Physical Therapy degree from the University of Saint Augustine for Health Sciences in 2012. Prior to that she had earned her B.S. in Clinical Exercise Science from Virginia Commonwealth University. In 2017 she became a certified yoga instructor (RYT-200) and in 2022, she became a Board Certified Orthopaedic Clinical Specialist. She has also received training in PreNatal/Postpartum Rehabilitation.
Nina's interest in Pelvic Health began during her graduate studies, when she realized how underserved this population was. She went on to complete a year-long residency program at Agile Physical Therapy to further her knowledge in helping women, men, and people of all gender identities regain confidence in their pelvic floor function. Nina understands how sensitive these issues are and hopes to help destigmatize bowel, bladder, and sexual dysfunction and empower people to seek the care they need to return to the activities they love.
this population was. She went on to complete a year-long residency program at Agile Physical Therapy to further her knowledge in helping women, men, and people of all gender identities regain confidence in their pelvic floor function. Nina understands how sensitive these issues are and hopes to help destigmatize bowel, bladder, and sexual dysfunction and empower people to seek the care they need to return to the activities they love.